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Special Issue "Personalized Management, Clinical Evaluation and Imaging of Scoliosis and Spinal Disorders"

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Department of Orthopaedic Surgery, Beijing Chaoyang Hospital, Beijing 100020, China
Interests: diagnosis and treatment of spinal degenerative disorders and spinal deformities

Special Issue Information

Dear Colleagues,

Spinal disorders such as spinal degenerative disease, spinal deformity, trauma and tumor are highly demanding for the diagnosis and treatment of orthopedic doctors due to their variable and distinctive characteristics. According to the clinical and imaging examination characteristics of different patients, it is a necessary skill for the orthopedic surgeon to plan an individualized and precise surgical strategy for each patient. As the “precision medicine” era progresses, it is the pursuit of surgeons to strive for more accurate and efficient surgical treatment options. Various emerging technologies, such as 3D, VR and AR technology, have developed rapidly in recent years, and have gradually become favorable tools for surgeons to handle these complex conditions. At present, such technology is still in its infancy in the personalized diagnosis and treatment of spinal diseases.

The aim of this Special Issue is to collect the latest research on personalized clinical and imaging evaluation as well as novel techniques related to the diagnosis and treatment of spinal disorders. This Issue will cover both clinical and basic research. Contributions of original research are extremely welcome if they provide new ideas for the personalized evaluation of spinal disorders and/or the development and application of novel therapeutics and techniques for use in the individualized treatment of spinal disorders. Review articles that help us to better understand the existing knowledge regarding the clinical evaluation, imaging, and personalized management of scoliosis and spinal disorders are also encouraged.

Prof. Dr. Yong Hai
Guest Editor

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Keywords

spinal deformity
spinal disorders
computer-assisted design
patient-specific
three-dimensional simulation
three-dimensional printing
guide template
virtual reality
augmented reality
artificial intelligence diagnosis

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Research

Open AccessArticle

Apical Vertebras Distribution Modifier for Coronal Balance Classification in Adult Idiopathic Scoliosis

and

J. Pers. Med. 2023, 13(6), 897; https://doi.org/10.3390/jpm13060897 - 26 May 2023

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Abstract

Background: We aimed to propose the apical vertebras distribution modifier to supplement the coronal balance (CB) classification for adult idiopathic scoliosis (AdIS). An algorithm to predict postoperative coronal compensation and avoid postoperative coronal imbalance (CIB) was proposed. Methods: Patients were categorized into CB and CIB groups according to the preoperative coronal balance distance (CBD). The apical vertebras distribution modifier was defined as negative (−) if the centers of the apical vertebras (CoAVs) were on either side of the central sacral vertical line (CSVL) and positive (+) if the CoAVs were on the same side of the CSVL. Results: A total of 80 AdIS patients, with an average age of 25.97 ± 9.20 years, who underwent posterior spinal fusion (PSF) were prospectively recruited. The mean Cobb angle of the main curve was 107.25 ± 21.11 degrees at preoperation. The mean follow-up time was 3.76 ± 1.38 (2–8) years. At postoperation and follow-up, CIB occurred in 7 (70%) and 4 (40%) CB− patients, 23 (50%) and 13 (28.26%) CB+ patients, 6 (60%) and 6 (60%) CIB− patients, and 9 (64.29%) and 10 (71.43%) CIB+ patients. Health-related quality of life (HRQoL) was significantly better in the CIB− group compared with that of the CIB+ group in the dimension of back pain. To avoid postoperative CIB, the correction rate of the main curve (CRMC) should match the compensatory curve for CB−/+ patients; the CRMC should be greater than the compensatory curve for CIB− patients; and the CRMC should be less than the compensatory curve for CIB+ patients, and the inclination of the LIV needs to be reduced. Conclusions: CB+ patients have the least postoperative CIB rate and the best coronal compensatory ability. CIB+ patients are at a high risk of postoperative CIB and have the poorest coronal compensatory capacity in the event of postoperative CIB. The proposed surgical algorithm facilitates the handling of each type of coronal alignment. Full article

(This article belongs to the Special Issue Personalized Management, Clinical Evaluation and Imaging of Scoliosis and Spinal Disorders)

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Open AccessArticle

Clinical Application of Personalized Digital Surgical Planning and Precise Execution for Severe and Complex Adult Spinal Deformity Correction Utilizing 3D Printing Techniques

and

J. Pers. Med. 2023, 13(4), 602; https://doi.org/10.3390/jpm13040602 - 30 Mar 2023

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Abstract

(1) Background: The three-dimensional printing (3DP) technique has been reported to be of great utility in spine surgery. The purpose of this study is to report the clinical application of personalized preoperative digital planning and a 3DP guidance template in the treatment of severe and complex adult spinal deformity. (2) Methods: eight adult patients with severe rigid kyphoscoliosis were given personalized surgical simulation based on the preoperative radiological data. Guidance templates for screw insertion and osteotomy were designed and manufactured according to the planning protocol and used during the correction surgery. The perioperative, and radiological parameters and complications, including surgery duration, estimated blood loss, pre- and post-operative cobb angle, trunk balance, and precision of osteotomy operation with screw implantation were collected retrospectively and analyzed to evaluate the clinical efficacy and safety of this technique. (3) Results: Of the eight patients, the primary pathology of scoliosis included two adult idiopathic scoliosis (ADIS), four congenital scoliosis (CS), one ankylosing spondylitis (AS), and one tuberculosis (TB). Two patients had a previous history of spinal surgery. Three pedicle subtraction osteotomies (PSOs) and five vertebral column resection (VCR) osteotomies were successfully performed with the application of the guide templates. The main cobb angle was corrected from 99.33° to 34.17°, and the kyphosis was corrected from 110.00° to 42.00°. The ratio of osteotomy execution and simulation was 97.02%. In the cohort, the average screw accuracy was 93.04%. (4) Conclusions: The clinical application of personalized digital surgical planning and precise execution via 3D printing guidance templates in the treatment of severe adult rigid deformity is feasible, effective, and easily generalizable. The preoperative osteotomy simulation was executed with high precision, utilizing personalized designed guidance templates. This technique can be used to reduce the surgical risk and difficulty of screw placement and high-level osteotomy. Full article

(This article belongs to the Special Issue Personalized Management, Clinical Evaluation and Imaging of Scoliosis and Spinal Disorders)

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Special Issue "Personalized Management, Clinical Evaluation and Imaging of Scoliosis and Spinal Disorders"

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